Poor Lip seal/Weak Suck

I posted earlier about the news that my daughter had a poor lip seal and a weak suck. This I learned caused her to suck at the breast for hours and transfer small amounts of milk. Through a series of feed an weighs, I was able to determine that she transfers a lot more almost an adequate amount when I massage and squeeze the breast while she is nursing.
I have a high quantity of milk especially early in the day. 10 ounces after the first feeding of the morning. I pump because I work full time. She gets bottles at school and is realitivly happy.
Night time at home is a different story. I supplement with an ounce or two of expressed milk from the bottle before I nurse her in the evenings because even with my help she is only able to transfer an ounce or so. I would let her nurse as long as she wanted in the evenings, but she will suck for ten minutes or so and get furious. Does anyone have suggestions for boosting evening milk supply. My other option is to simply pump and give her the exppressed milk all the time, but I really love the closeness that comes from holding her.
Suggestions are greatly appreciated.

Re: Poor Lip seal/Weak Suck

What size nipple are you offering on her bottles at DCP? I'm wondering if they are more than a newborn/slow flow and causing your baby to want milk quicker. Breastfed babies should stay on newborn size nipples on bottles as long as they take bottles.

Also, how old is your baby? Maybe it's a growth spurt. The best way to deal with that is to just keep switching sides.

Christine
Baby Girl Born 2/17/10 to her two mommies
BF from day one. I looked up one day and realized I'm nursing a toddler!

Re: Poor Lip seal/Weak Suck

She uses the slowest flow that Medela offers. We have also tried the tommy tipee which also has a slow flow, but just like trying to nurse, because of the wide nipple base she has trouble getting a good seal. Which would not be a huge deal other than the fact that she swallows lots of air and that makes her tummy bubble and hurt. My daughter will be 10 weeks on Monday.

Re: Poor Lip seal/Weak Suck

best way to boost supply is to just switch her back and forth as long as you can. try to switch her before she's furious and get her working on the other side. make sure you're drinking enough water, too.

good luck! i really encourage you to hang in there with the nursing because the strong likelihood is she'll get better at it, and in the long run it is WAY easier than exclusive pumping. you really do - as you said - want to keep the nursing experience, so it's important you keep bringing her to the breast when you're together. even if you always have to pump to supplement - and you might not always, if she gets a better suck - nursing is so important for both of you (for emotional & bonding reasons, and it'll still help you soothe hurts and put her to sleep and all that).

Re: Poor Lip seal/Weak Suck

Not sure why she has such a weak seal. We have an evaluation with ECI this week and hopefully they will have some insight. I am continuing to nurse, but my nipples are cracked and painful because she has such a poor latch. I am hoping for some relief soon because everything hurts.

Re: Poor Lip seal/Weak Suck

OK I looked back and see an LC diagnosed the weak seal. This painful latch is really dragging on for you! Have you gone back to her or to anyone else for followup? What about thrush, was that ruled out as a problem or treated?

Are you saying you can pump 10 ounces in one session? That sounds like oversupply-yes we tend to have more milk in the morning but that is quite a lot.-is that after nursing? Does baby nurse at all overnight? Do you feel really full in the mornings? Do you also pump during the work day? How does pumping feel?

Anyway, I really do not know how you can boost evening supply specifically, you would just have to try boosting supply overall (you could consider galactagogues, anything from oatmeal to more milk cookies to herbals to prescription galactagoges) and see what happens-but I would be really concerned that would make any possible oversupply worse- Of course you will need to continue removing milk regularly via pumping and/or nursing...A lower amount of milk in the evening is normal, as is evening fussiness like you describe. As long as baby is gaining/getting enough milk OVERALL, I would suggest you do not need to worry so much about the transfer being lower at that time of day, as again, that would be normal- it encourages baby to nurse alot which would help with production. But that does not solve your problem of nursing being really painful!

Has anything helped with the latch pain? Different positions, different latch techniques, baby being calm when nursing, baby crying when nursing-anything that you notice helps, even a little bit? Is it less or more painful at any particular time of day? Does the amount of milk you have in your breasts make any difference? Do you have visible nipple injury?

Re: Poor Lip seal/Weak Suck

I have a large supply in the morning yes. The baby has been sleeping 7-8 hours over night. I have tried to continue to nurse over night, but getting the latch correct is such an issue as is the sucking, she simply goes back to sleep after a few sucks. I pump at work at least twice while I am there. The thrush was treated in both of us and the baby looks a lot better (her tounge looked like she drank white paint) I however still have some pain but I really feel it is a latch issue. My nipples look like lipstick which I know is a sign of poor latch. I have tried different positions for the latch, but if I can not express for her with my hand while she nurses, she doesn't transfer much of anything. She is gaining weight, her wet diapers are at least 7-8 a day. Dirty diapers are yellow and seedy. I only have dirtys every two to three days but she is older than 6 weeks so I am guessing that is in the normal range. She seems to be making due, but I feel like I am fighting an uphill battle. Pumping hurts but some days not as much as nursing. I have not been back to lactation because I can not afford it this month but after we have the baby looked at I am hoping to go back with new information. Thank you all for comments and support.